Scout Personal Data Collection FormName:________________________________________Nickname:____________________BSA ID#:____________________Sex:M / FAddress:______________________________Mailing:______________________________________________________________________________________________________________________________________________________Phone(s) Home:(___) __________DOB:__/__/_______________:(___) __________Grade:__________________:(___) __________School:______________________________Email:______________________________Joined Unit:__/__/__Cub Scout:__/__/__ - __/__/__Highest Cub Badge:_______________Boys Life:Y / NHealth form on file:Y / NEmergency Contact:_________________Phone:(___) __________Class 1 Phys:__/__/__Doctor:_________________Phone:(___) __________Class 2 Phys:__/__/__Insurance:_________________Policy:____________Class 3 Phys:__/__/__Allergies:____________________________________________________________Other:____________________________________________________________Prior Experience:FromToLevelUnit #Council #__/__/____/__/____________________________/__/____/__/____________________________/__/____/__/____________________________/__/____/__/__________________________Father:______________________________Mother:______________________________Nickname:______________________________Nickname:______________________________Guardian:Y / NGuardian:Y / NPhone(s) Work:_______________Phone(s) Work:___________________________:___________________________:___________________________:___________________________:_______________Email:_________________________Email:______________________________Drivers Lic:_______________ST:___Drivers Lic:_______________ST:___Employer:______________________________Employer:______________________________Occupation:______________________________Occupation:______________________________Insurance (in thousands)Vehicle(s) (Year/Make/Model)# BeltsLic PlatePer PersonPer AccidentProperty________________________________________________________________________________________________________________________________Remarks:____________________________________________________________